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Use of systemic corticosteroids for atopic dermatitis: International Eczema Council consensus statement
Author(s) -
Drucker A.M.,
Eyerich K.,
de BruinWeller M.S.,
Thyssen J.P.,
Spuls P.I.,
Irvine A.D.,
Girolomoni G.,
Dhar S.,
Flohr C.,
Murrell D.F.,
Paller A.S.,
GuttmanYassky E.
Publication year - 2018
Publication title -
british journal of dermatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.304
H-Index - 179
eISSN - 1365-2133
pISSN - 0007-0963
DOI - 10.1111/bjd.15928
Subject(s) - medicine , systemic therapy , statement (logic) , atopic dermatitis , anticipation (artificial intelligence) , consensus conference , quality of life (healthcare) , family medicine , pediatrics , intensive care medicine , dermatology , political science , cancer , breast cancer , law , nursing , artificial intelligence , computer science
Summary Background Guidelines discourage the use of systemic corticosteroids for atopic dermatitis ( AD ), but their use remains widespread. Objectives To reach consensus among an international group of AD experts on the use of systemic corticosteroids for AD . Methods A survey consisting of statements accompanied by visual analogue scales ranging from ‘strongly disagree’ to ‘neutral’ to ‘strongly agree’ was distributed to the International Eczema Council ( IEC ). Consensus was reached in agreement on a statement if < 30% of respondents marked to the left of ‘neutral’ towards ‘strongly disagree’. Results Sixty of 77 (78%) IEC members participated. Consensus was reached on 12 statements, including that systemic corticosteroids should generally be avoided but can be used rarely for severe AD under certain circumstances, including a lack of other treatment options, as a bridge to other systemic therapies or phototherapy, during acute flares in need of immediate relief, in anticipation of a major life event or in the most severe cases. If used, treatment should be limited to the short term. Most respondents agreed that systemic corticosteroids should never be used in children, but consensus was not reached on that statement. The conclusions of our expert group are limited by a dearth of high‐quality published evidence. If more stringent consensus criteria were applied (e.g. requiring < 20% of respondents marking towards ‘strongly disagree’), consensus would have been reached on fewer statements. Conclusions Based on expert opinion from the IEC , routine use of systemic corticosteroids for AD is generally discouraged and should be reserved for special circumstances.